The expatriate, who tends to be a sophisticated individual, is likely aware of developments in medical science and of the diversity of treatments and medications available.

Therefore, balancing their health care needs and expectations with the company's policy and budget can be tricky.

"The expatriate community network is a very powerful machine and expatriates compare their company benefits amongst themselves," says Andrew Apps, European business manager for Goodhealth Worldwide, a UK-based insurance company that deals with individuals and small- to medium-sized companies. "The demand also comes from the companies, who want to ensure that their expatriate workers, in whom they have heavily invested, are as productive as possible and that, should they fall ill, things can be sorted out quickly and efficiently."

Flexible policies to fit the expat    

To satisfy demanding expatriates, companies need to be willing to offer a range of health care options.

"Health policies need to be flexible to reflect the increase in medical treatment options," says Marc Posthuma, sales director Benelux for CIGNA International, which specialises in corporate contracts.

According to Apps, the international medical insurance market has responded to changing ideas about treatment and demands for broader coverage. Policies today can often include extras alongside the base product.

Sarah Marfleet, senior marketing controller International Development AXA PPP healthcare, confirms this assessment.

“Though some companies may only wish to provide a generic healthcare package, increasingly companies are expecting a broader range of cover for their expatriate employees, with benefits such as cover for chronic conditions, HIV and war risks," she explains.

BUPA International, for example, which bills itself as the largest international expatriate health insurer in the world, recently launched a new plan that is centred around the fact that it can be tailored to suit customers’ individual needs. The plan covers everything from specialist treatment and prescribed medicines to medical equipment health screening, vaccinations, dental and optical treatment and worldwide evacuation for people who are unable to get the treatment they need in a local hospital.  

“Bupa Worldwide Health Options has been in development for 18 months,” says David Grint, commercial director for Bupa International. “We have listened to our customers and taken the ‘best in class’ to create one powerful solution that works around the world offering more choice without additional complexity.”

Assuring peace of mind    

Along with culture and language training and career assistance for trailing spouses, health care is an important part of an expatriate's overall package. But quality health coverage probably has more impact on an expatriate's peace of mind than other aspects of the package.

As Posthuma explains: "The most important need of the employee and family is that they are assured of direct access to medical care. They need to have the feeling that any medical problem will be solved right away."

“Expats need an insurance partner with an international expertise,” adds Alfred Goebels, Head of Products and Underwriting at DKV Globality, an international insurance company with a focus on the expat community. “They need someone that is familiar with local structures, someone who knows which people to contact in each situation and ensures that they receive optimum, flexible and multidisciplinary support.”
 

State systems versus private health coverage    

There is always the option of using the host country’s state social system though in certain countries this may be closed to foreigners or even compulsory.

However, state provisions, which have been designed for domestic needs, give limited cover, longer waiting times for treatment and provide a level of service below what an internationally mobile employee might need.

International plans, though costly, replace all other plans or state systems, give clients the freedom to choose a medical provider and are transportable.

France is a good example of a country that demands that everyone registered as working there join the social system, but it has a cost limit.

Apps says, “Goodhealth is unique in the market in that we provide Premier, a ‘top up’ product for people working in France, which works in conjunction with the state’s social system."

Expatica/ Natasha Gunn

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